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Utilization of surgical procedures and racial disparity in the treatment of urinary incontinence after prostatectomy
Author(s) -
Gupta Shubham,
Ding Laura,
Granieri Michael,
Le NgocBich,
Peterson Andrew C.
Publication year - 2016
Publication title -
neurourology and urodynamics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 90
eISSN - 1520-6777
pISSN - 0733-2467
DOI - 10.1002/nau.22790
Subject(s) - medicine , prostatectomy , urinary incontinence , open prostatectomy , urology , prostate cancer , artificial urinary sphincter , surgery , cancer
Aims To analyze the rates of incontinence procedures after radical prostatectomy, and define the variables associated with them. Methods We conducted an IRB approved retrospective review of patients with prostate cancer who underwent radical prostatectomy at a single institute from January 1998 to December 2012. Logistic regression and time to event analyses were performed to ascertain variables associated with receipt of incontinence procedure after prostatectomy. Results Four thousand four hundred one men underwent radical prostatectomy (69.8% open, 30.1% laparoscopic or robotic) of whom 74.3% were white Caucasian and 22.1% were African‐American. Overall, 165 (3.7%) patients underwent a total of 191 procedures for male urethral sling or artificial urinary sphincter placement. African‐American men received fewer incontinence procedures than white Caucasian men (2.1% versus 4.3%, P = 0.001); and with a longer delay after prostatectomy than white Caucasian men (28.3 months versus 19.9 months, P = 0.029). Men who had a laparoscopic or robotic prostatectomy received an incontinence procedure earlier than men who had an open prostatectomy (17.6 months versus 24.4 months, P = 0.0001). On multivariate analysis, age at prostatectomy, diagnosis of incontinence, and race were independently associated with receiving an incontinence procedure. Conclusions The overall rate of incontinence surgery after radical prostatectomy is low at 3.7%. African‐American men receive incontinence procedures at a lower rate and with a longer delay after prostatectomy than white Caucasian men. Further studies are needed to define the reasons for this racial disparity in urinary incontinence surgery in the prostate cancer survivor. Neurourol. Urodynam. 35:733–737, 2016 . © 2015 Wiley Periodicals, Inc.